1. Field of the Invention
This invention relates to a device for fastening tissue during the process of a surgical procedure on a subject. More particularly the present invention is directed to a stapling device, which can be used to close the peritoneal side of a stab wound, which is associated with a laparoscopic surgical procedure.
2. Description of Related Art
The use of staples and staple insertion devices for the closure of surgical wounds to the skin and fascia of a subject are well known and used in the surgical arts. Laparoscopic surgical procedures have increased in number substantially over the past few years. However, the closure of wounds associated with laparoscopic procedures still primarily relies on conventional manual suturing methods. With more advances in surgical instrumentation the number of laparoscopic procedures done annually is estimated at over ten million a year in the United States alone. The instrumentation used for deep tissue closure of tissue at the conclusion of laparoscopic surgery remains the needle holder and suture. Although laparoscopic surgical procedures are minimally invasive using relatively thin trocars to penetrate into the abdominal cavity, the resulting openings or stab wounds, which are caused in the abdominal wall are extremely difficult to close upon completion of the surgery. Typically, the openings are approximately twelve millimeters in size and prove extremely awkward and time consuming to close using conventional suturing methods with traditional handheld needle holders and suture. The use of this conventional methodology is difficult for the surgeon to properly accomplish and further is potentially hazardous for the surgical patient.
A growing number of postoperative complications in the form of hernias, which often require open closure, have been observed as the number of laparoscopic procedures has increased. Such postoperative problems are a result of not placing a deep stitch in the peritoneal side of the stab wound because of the difficulty associated with doing it or inadequately placing the suture needed to close the deep tissue of the wound. Incisions, which are smaller than the typical size of about twelve millimeters do not have a nearly so significant rate of complications.
While stapling devices have been designed and provided for other surgical procedures, none of the conventional surgical stapling devices are designed for the special requirements of deep tissue closure in laparoscopic procedures. A growing need exists for a stapling device which can be used to effectively penetrate the opposite sides of a deep wound and effect a suitable closure of the wound.
Currently used stapling devices are well suited to the particular needs for which they were designed but are hardly adaptable for use in deep tissue closure following laparoscopic surgery. U.S. Pat. No. 5,915,615, issued to Bauer, discloses a manually operated fastening device for use in meeting the specialized requirements of fastening septal tissue within the narrow passages of the nose during septal surgery. While this fastening device is effective for fastening septal tissue it would be unsuitable for the requirement for a deep tissue stapling device described in the present application. Another specialized instrument is disclosed in U.S. Pat. No. 4,394,864 issued to Sandaus, which discloses a vas occlusion device that includes jaw members for holding open a locking clip and for penetrating tissue in which the clip is to be closed. Both of these prior art devices adequately meet the specific needs for the surgical procedures, which are discussed in their disclosures but fail to provide an adequate substitute for the currently used needle holder and suture. For this reason, surgeons today continue to manually suture the deep tissue of a laparoscopic surgical wound.
Another well known mechanical surgical fastening device is taught in U.S. Pat. No. 4,997,436 issued to Oberlander. The Oberlander patent is directed to an arthoscopic clip insertion device with jaws that hold a biodegradable clip, the jaws having sharpened tips to facilitate insertion of the clip into soft tissue or fibrocartilage. U.S. Pat. No. 5,456,400 issued to Schichman et al., discloses a surgical fastener that has pre-piercing members that penetrate body tissue to facilitate insertion of a clip therein and to close the clip. Another example of a conventional fastening or clipping device which is well known in the surgical arts but which is equally wholly unsuited to the need for a deep tissue closure device is taught by U.S. Pat. No. 4,569,346 issued to Poirer. The Poirer apparatus is an occluding device for applying two clips and cutting the tissue positioned there between. None of the conventional stapling, fastening, or clipping devices currently known and used in the surgical art are capable of effectively and consistently performing closure of deep tissue following laparoscopic surgery.
The conventional procedure for manually suturing the peritoneal side of a laparoscopic surgical wound has proven to be inadequate to avoid the many complications that increasingly present post surgically. None of the conventional mechanized stapling devices, as represented by the selected U.S. Patents discussed above, teach or suggest an instrument that could adequately meet the need for an effective and safe stapling device for use in closing the peritoneal side of a laparoscopic surgical wound. The inventor has designed the present invention to meet that very particular requirement.